Hospitals often use quick but flawed tests to screen pregnant patients for illegal drug use. Ingesting an array of things before a urine screen—heartburn medicine like Zantac, ADHD medication, food with poppy seeds like salads and muffins—can lead to false positive results. For The Marshall Project, Shoshana Walter interviewed dozens of patients, medical providers, toxicologists, and other experts, and found that more than 50 mothers across 22 states faced child welfare reports and investigations over positive tests that were likely wrong. Shockingly, hospitals in the US routinely report patients to authorities without confirmation testing and additional review—leading to unnecessary and sometimes lengthy separations of newborns from their parents.
To differentiate between salad dressing or bagels and illicit drugs, toxicologists have long recommended testing urine for the presence of a compound called thebaine, which is found in poppy seeds, but not in heroin. There’s no indication that the hospital performed or even knew about the thebaine test, leaving providers with no way to prove or disprove Horton’s claims.
“Mom and dad insistent that a Costco salad with poppyseed dressing is responsible,” a doctor wrote in her notes. Another doctor wrote: “We are unable to verify whether this could result in a positive test.”
Soon, multiple doctors and nurses filed into Horton’s room. They said hospital policy dictated that Halle remain there for five days to be monitored for possible drug withdrawal symptoms — “for baby’s safety,” a doctor told Horton.
Unlike most other states that require hospitals to report positive drug tests, California law says a positive test alone “is not in and of itself a sufficient basis for reporting child abuse or neglect.” But because of COVID-19 and her son’s heart condition, Horton had also missed some prenatal appointments, which many providers see as a red flag for drug use. A hospital social worker noted the missed appointments and decided to file a report.
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